25 year old female IT professional (and representative AFL player)
Reason for coming to Barefoot Physiotherapy:
The client ruptured the ACL (Anterior Cruciate Ligament) of her left knee at AFL training in April. Knee reconstruction performed in June and coming to Barefoot for rehabilitation post operation.
Goal = Post operative rehab – return to AFL and Gridiron training and games.
Moderately swollen left knee with operative scars for ACL reconstruction
Partial-weightbearing in a Richards splint using crutches to walk
40% active movement at the knee joint
Overactive hip, thigh and calf muscles bilaterally due to injury/operation/crutch use
Poor muscle activation around the knee and hip
Swelling management (taught self massage/rocktape/positions and ongoing measurements to ensure effective)
Post op management (eg scar/crutch use/DVT avoidance)
Taping and teaching client to self tape
Dry needling and trigger point release of muscles around knee and hip (Vastus lateralis, Rectus Femoris, Adductor Magnus, Hamsting)
Home exercise program (daily) of range of motion, muscle releases, strength, balance/proprioception and walking practice.
Once able: Gym program progressing from home exercises through to full sports specific drills and strength
Outcome (16 sessions in 6 months):
Cleared by surgeon to play Gridiron
No neural irritation
Full Active movement of the knee
Full strength of squat/lunge/jumping/landing – all in straight line (change of direction 100% at 8 months)
100% Balance on single leg
Influences on the Result:
Client was committed to rehab and getting back to playing AFL. Of note the surgeon cleared her to play Gridiron earlier than AFL due to the difference in predictability of forces on the knee (AFL being less predictable therefore higher level required). The client was taught self treatment techniques for swelling/taping/releases and did these consistently therefore reducing her need for treatment in the clinic. First 2 appointments were an hour.